| NPI | 1194866889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD450126) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 029034) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-21 |